OPEN ENROLLMENT IS OVER! OR IS IT???

The Department of Health and Human Services established an Open Enrollment Period for 2015 starting on November 15, 2014 and ending on February1 5, 2015. During that time a reported 10 million Americas enrolled in quality health insurance.

It’s worth reviewing some of the Essential Benefits mandated by the Affordable Care Act. Although the Plans were divided into 4 categories: Bronze, Silver, Gold and Platinum, they all have these Essential Benefits in common.
• All Plans provide for Annual Wellness Exams at NO COST.
• All limits to be paid by the Insurance Company have been removed.
• All pre-existing conditions are covered, allowing thousands of previously uninsurable to get the coverage and treatments they need.

Health Market Agents in 45 States assisted, advised and aided approximately 1,500,000 applicants to secure the health insurance and supplemental protection that was determined to be the best option for themselves or their families.

Many applicants had misunderstandings about available policies, selection of doctors, and the availability to receive tax credits (subsidies) to help pay for their Insurance. Few realized that they could use their tax credit for any plan offered through the Marketplace; the average number across the US was 40 available plans.

The Average monthly tax credit was $268.00. Personally, I assisted individuals and families to qualify for tax credits over $1,000 per month.

I helped a woman, who is a Cancer patient, enroll in a plan for $50 per month. The plan she selected will cover all of her treatments for the year, with her MAXIMUM OUT OF POCKET EXPENSE limited to $500. Another woman with congenital heart disease is now able to get a much-needed surgery with a plan that has a monthly premium of $72 and maximum out of pocket cost of $1,100.

The Marketplace estimates that 87% of applicants received a tax credit, most of whom were previously uninsured or unable to pay for 100% of their Health Insurance prior to enrolling.

While all of that is positive, what happens to someone needing health insurance now that the enrollment period is CLOSED?

When originally designed, the Affordable Care Act provided for Special Election Periods for those experiencing a “life changing event” within 60 days of application submission. Examples of such events include: marriage, divorce, pregnancy, loss of employment, loss of insurance (not voluntary), and change of immigration status.

Special Election Period opens enrollment during tax season.
In addition, on Friday, February 20, 2015, the Centers for Medicare and Medicaid Services (CMS) announced a Special Election Period for the tax season. This period begins March 15 and ends April 30 at 11:59 PM.

This extension period permits those that were unaware of or didn’t understand the implications of the fee (penalty) for not enrolling in accredited coverage for at least nine months in 2014 to choose a plan that best meets their needs.

So, what does this mean for you?
This opens the door to many still in need of assistance.
• Do you qualify for a Special Election?
• Do you need help determining if you qualify for a tax credit?
• Do you want to know how much credit you will receive?
• Do you need clarification on what plans and doctors are available in your area?

If you answered yes to any of the above questions, I CAN HELP! With a few questions and a five minute phone call, I can help you determine if you qualify for this most recent Special Election Period extension.

I have helped hundreds of people save thousands of dollars on health care coverage. Call today. I am happy to answer any questions you might have concerning the Affordable Care Act enrollment.

Vincent J Spinelli
239-919-3028